Routine inspection·May 25, 2022

On 05/25/2022 at 9:15 am, Licensing Program Analyst (LPA) T. White arrived unannounced to conduct a required 1-year annual inspection. LPA met with Caregiver, Amy Dolores and explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 15 residents. LPA later met with Administrator, Elizabeth Abesa who holds a certificate #6010093740 that expires on 10/26/2023. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 119.1 degrees Fahrenheit. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on February 09, 2022. First aid kit was observed to be complete. LPA observed completed mitigation plan. LPA reviewed 5 resident files and 3 staff record files. LPA observed the following deficiency: - LPA observed Staff #3 (S3) does not have a Health Screening or TB test on file. The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency may result in civil penalties. Exit interview conducted with Administrator. A copy of report and Appeal Rights given.